Healthcare Provider Details

I. General information

NPI: 1467453811
Provider Name (Legal Business Name): PETER G ZOGRAFIDES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

442 W HIGH ST
BRYAN OH
43506-1681
US

IV. Provider business mailing address

4235 SECOR RD
TOLEDO OH
43623-4231
US

V. Phone/Fax

Practice location:
  • Phone: 419-633-4530
  • Fax: 419-633-4532
Mailing address:
  • Phone: 419-479-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number35.069659
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: